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Use of the HLA B27 test in Auckland
The New Zealand Medical Journal
|October 10, 1984
Summary
This study found that non-rheumatologists frequently ordered Human Leukocyte Antigen B27 (HLA B27) tests for patients unlikely to have associated diseases, leading to excessive testing. Rheumatologists demonstrated more appropriate test ordering for HLA B27 associated conditions.
Area of Science:
- Immunogenetics
- Rheumatology
Background:
- Human Leukocyte Antigen B27 (HLA B27) is strongly associated with certain inflammatory diseases.
- Appropriate patient selection for HLA B27 testing is crucial for diagnostic efficiency.
Purpose of the Study:
- To assess the probability of HLA B27 associated disease in patients undergoing testing.
- To evaluate the appropriateness of HLA B27 test ordering by different medical specialties.
Main Methods:
- Retrospective analysis of 74 patient test results.
- Categorization of disease probability (definite, possible, very unlikely).
- Comparison of HLA B27 positivity rates between rheumatologists and non-rheumatologists.
Main Results:
- Of 74 patients, 6 had definite, 31 possible, and 37 very unlikely HLA B27 associated disease.
- Only 13 patients tested positive for HLA B27.
- Non-rheumatologists ordered significantly more tests (60) than rheumatologists (14), with lower positivity rates (12% vs 43%).
Conclusions:
- Non-rheumatologists ordered excessive HLA B27 tests in patients with low disease probability.
- Improved physician education on HLA B27 testing indications may reduce unnecessary investigations.